The Duke University School of Medicine along with the Duke University School of Nursing and Duke University Health System create Duke Health. Established in 1925 by James B. Duke, the School of Medicine has earned its reputation as an integral part of one of the world's foremost patient care and biomedical research institutions. Clinical rotations by medical students and residents occur within the Duke University Health System, a fully integrated academic health care system encompassing a tertiary-care hospital and specialty clinics on the Medical Center campus, two community hospitals, a VA hospital, home health and hospice services, a network of primary care physicians, and other affiliated partners across the SE United States. Duke University Hospital is consistently ranked among the top 20 of some 5,700 American hospitals by US News and World Report. Furthermore, the School of Medicine is especially noted for its groundbreaking biomedical research, bringing in nearly $700 million in NIH-sponsored projects in 2016.
While opioids are commonly prescribed for postoperative pain management, their use is recommended with caution in pediatric populations. In adult populations, patient sex has been identified as a predictor for increased opioid use, and understanding sex-related differences in postoperative pain is important for optimizing analgesia safety in adolescents undergoing posterior spinal fusion for idiopathic scoliosis. A single-institution retrospective cohort study was conducted on patients < 18 years who underwent corrective surgery for adolescent idiopathic scoliosis (AIS). Variables included patient demographics and socioeconomic factors. Primary outcomes were patient-reported pain scores on a 0–10 scale during the index hospitalization. Secondary outcomes included total inpatient opioid consumption (converted to morphine milligram equivalents), discharge opioid prescriptions, and rates of opioid refills. In total, 266 patients were analyzed, including 188 (71
Sepsis is characterized by dysregulated inflammation leading to organ dysfunction. While immune activation and metabolic stress are central features, accumulating evidence suggests that regulated cell death programs actively influence inflammatory trajectories rather than serving as passive end-stage events. Apoptosis, pyroptosis, necroptosis, ferroptosis, and neutrophil extracellular trap (NET) formation have each been implicated in sepsis; however, their relative hierarchy, temporal dynamics, and compartment-specific relevance remain incompletely defined. To synthesize current evidence on regulated cell death pathways in sepsis and to propose a phase-specific and compartment-oriented framework that integrates apoptotic, inflammatory lytic, and NET-associated mechanisms within a unified inflammatory model. A narrative review of experimental, translational, and clinical studies examining apoptosis, pyroptosis, necroptosis, ferroptosis, PANoptosis, and NETosis in sepsis and related inflammatory states was conducted. Emphasis was placed on signaling dependency, inflammatory consequences, temporal phase distinctions, and cellular compartment heterogeneity. Apoptosis remains the dominant leukocyte death program associated with late-phase immune depletion and immunosuppression. In contrast, inflammasome-mediated pyroptosis and RIPK1/RIPK3-dependent necroptosis amplify early hyperinflammatory responses by inducing membrane permeabilization and damage-associated molecular pattern release. Ferroptosis represents an emerging iron-dependent metabolic-inflammatory interface with potential organ-specific relevance, although clinical validation remains limited. NET formation, often interpreted as a distinct death program, is more appropriately understood as a context-dependent effector mechanism linking innate immunity to thromboinflammation rather than representing the predominant terminal fate of leukocytes in sepsis. Increasing evidence supports pathway crosstalk and PANoptotic integration, suggesting that regulated cell death programs function as overlapping inflammatory networks rather than isolated processes.
Musculoskeletal pain and mobility disability are common in older adults, but relationships among pain parameters and physical performance are poorly understood. We quantified the impact of different pain measures—recalled and movement-evoked pain—on walk and stair climb time in older adults from the Study of Muscle, Mobility and Aging (SOMMA). In SOMMA (N = 879, age = 76.3 ± 5.0 years, 59
PURPOSE:As cancer survivorship rises, provision of information during cancer care is increasingly important, especially regarding potential impacts on patients' health-related quality of life. We sought to understand information needs patients had before initiating anti-cancer treatment using data from a qualitative study designed to examine appropriate recall periods in patient-reported outcome measures of physical function (PF). In this secondary analysis from the Patient Reports of Physical Functioning Study (PROPS) research program, we report on: What do patients wish they had known about their PF before starting treatment? METHODS:In this secondary analysis, we examined transcripts from PROPS to describe what patients wish they had known about their PF before starting treatment. We used qualitative content analysis to analyze 72 semi-structured transcripts conducted with adults with cancer who had undergone anti-cancer treatment in the previous 6 months. The purpose of this analysis was to identify categories of patient information needs. RESULTS:Of the 72 participants, over half indicated a desire for additional information about their PF before starting treatment, including the impact of side effects/symptoms, such as pain and fatigue, on PF, or a better understanding of expectations for PF. Most of these participants reported PF limitations during the interview. The remaining participants reported feeling fully informed, with most reporting no PF limitations. CONCLUSION:Patients are interested in learning about the impact of treatment on their PF, but the amount of detail desired varies. Providing personalized information may enhance shared decision-making, empower patients in self-management and treatment decisions, and support timely referrals to specialists. These findings highlight the need for tailored communication strategies in cancer care to better address patient concerns and improve overall treatment experiences.
Early deep wound infection complicates an estimated 4
